Abstract 852P
Background
Conventional, induction chemotherapy induces remission in up to 70% of patients of AML aged <60 years and in only 30% to 50% of older patientsdue to unfavourable prognostic factors and treatment mortality. Intensive chemotherapy may not be suited for elderly and in poor performance status young patients who have other medical comorbid illness and underlying infections.By this study we aim to achieve a shorter duration of treatment instead of indefinitive treatment with acceptable survival outcomes and safety profile by giving Ara C consolidation once remission is achieved by hypomethylating agents.
Methods
20 patients who acheived CR with hypomethlating agents during september 2018 to september 2020 were given 3-4 cycles of consolidation Ara C3(gm/m2 BD for 3 days) every 4 weeks.All the patients were followed up every 3 months till january 2021.
Results
At a median follow up of 10 months, median OS was not reached as only 15% events had occurred. 35% patients are having a survival of 1 year or longer with longest follow of ongoing survival being 26 months. Median Relapse free survival was 14.8 months (95% CI: 6.4-23.1). The median duration of grade IV neutropenia was 12 days (range: 5–23 days). Out of 70 cycles of HiDAC Neutropenic fever (>38 ◦C) occurred in 42 cycles (60%).10 episodes (14%) developed septic shock requiring inotropic support and ICU admission. Out of 42 episodes of neutropenic fever 7 episodes required empirical antifungals.Out of 42 episodes of neutropenic fever focus was identified in 30 of them. There was no death due to neutropenic fever or other complications of HiDAC.
Conclusions
The major scope of our study was to demonstrate the feasibility and safety of consolidation with HiDAC in patients who achieved CR with hypomethylating agents with meaningful survival outcome and fair toxicity profile. Our data provide preliminary evidence for the excellent activity and safety of HiDAC among patients achieved CR with hypomethylating agents. The safety profile with this study is comparable to the standard with a meaningful survival benefit. Further studies are required to validate our findings and to explore various predictive and prognostic factors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.